社会支持网络、自我效能及健康促进行为对老年人影响的路径分析

doi:10.3761/j.issn.0254-1769.2019.11.021

摘要/Abstract

摘要：

目的探讨社会支持网络、自我效能及健康促进行为对社区老年人健康老龄化的影响,并分析其路径。方法 2017年7月—12月,采用横断面调查法,应用社会网络量表、医疗社会支持量表、健康实践自我效能量表、健康促进生活型态量表Ⅱ及健康老龄化量表对北京市4个城区的485名社区老年人进行调查。结果社区老年人的健康老龄化量表总得分为（120.62±23.15）分。邻居关系对健康老龄化既有直接影响也有间接影响,总效应为0.225;家属支持可促进健康老龄化,总效应为0.194;自我效能能够通过直接和间接作用影响健康老龄化,总效应为0.701。结论社区老年人的健康老龄化总体水平处于中等偏上,但在保持良好认知功能和社交参与维度的得分较低。邻居关系、家属支持以及自我效能是影响个体健康老龄化的关键因素。

关键词: 老年人, 社会支持, 自我效能, 健康行为, 老年护理学

Abstract:

Objective To explore the impact of social support network,self-efficacy and health promotion behavior on healthy aging of elderly in community,and to analyze the influence path.Methods From July to December,2017,a cross-sectional survey was conducted among 485 older adults in four districts of Beijing. Data were collected by using the Lubben Social Network Scale,Medical Outcomes Study Social Support Survey,Self-rated Abilities for Health Practices Scale,the Health-Promoting Lifestyle Profile II and Healthy Aging Instrument.Results The total score of healthy aging of older adults was（120.62±23.15）. Neighborhood relationship had both direct and indirect effects on healthy aging,and the total effect was 0.225. Family support had the strongest effect on promoting healthy aging（β=0.194）. Self-efficacy could directly and indirectly affect healthy aging,and the total effect was 0.701.Conclusion The overall level of healthy aging of older adults was at the upper middle level,but the scores of cognitive function and social participation dimension were low. Neighborhood relationship,family support and self-efficacy were the key factors affecting healthy aging of individuals.

Key words: Aged, Social Support, Self-efficacy, Health Behavior, Geriatric Nursing

吴凡, 绳宇. 社会支持网络、自我效能及健康促进行为对老年人影响的路径分析[J]. 中华护理杂志, 2019, 54(11): 1701-1706.

WU Fan, SHENG Yu. Pathway analysis of impact of social support network,self-efficacy and health promotion behavior on healthy aging among older adults[J]. Chinese Journal of Nursing, 2019, 54(11): 1701-1706.

图/表 2

参考文献 31

[1]	World Health Organization. What is healthy ageing?[EB/OL]. [2018-12-12]. .
[2]	Ayalon L, Levkovich I . A systematic review of research on social networks of older adults[J]. Gerontologist, 2019,59(3):e164-e176.
[3]	Cornwell B, Schumm LP, Laumann EO , et al. Assessment of social network change in a national longitudinal survey[J]. J Ge-rontol B Psychol Sci Soc Sci, 2014,69(Suppl 2):S75-S82.
[4]	Courtin E, Knapp M . Social isolation,loneliness and health in old age:a scoping review[J]. Health Soc Care Community, 2017,25(3):799-812.
[5]	余昌妹, 吴永琴, 杨晔琴 , 等. 温州市社区空巢老人社会支持与生活质量的相关性研究[J]. 中华护理杂志, 2008,43(5):465-467.
[6]	Berkman LF, Glass T, Brissette I , et al. From social integration to health:durkheim in the new millennium[J]. Soc Sci Med, 2000,51(6):843-857.
[7]	Park S, Kang JY, Chadiha LA . Social network types,health,and health-care use among South Korean older adults[J]. Res Aging, 2018,40(2):131-154.
[8]	刘莉莉, 林平, 赵振娟 . 自我效能、社会支持及应对方式对急性心肌梗死患者心理弹性影响的路径分析[J]. 中华护理杂志, 2016,51(1):21-25.
[9]	Lindsay Smith G, Banting L, Eime R , et al. The association between social support and physical activity in older adults:a systematic review[J]. Int J Behav Nutr Phys Act, 2017,14:56.
[10]	Manasatchakun P, Chotiga P, Hochwälder J , et al. Factors associated with healthy aging among older persons in northeastern Thailand[J]. J Cross Cult Gerontol, 2016,31(4):369-384.
[11]	Lubben J, Blozik E, Gillmann G , et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations[J]. Gerontologist, 2006,46(4):503-513.
[12]	Sherbourne CD, Stewart AL . The MOS social support survey[J]. Soc Sci Med, 1991,32(6):705-714.
[13]	Walker SN, Sechrist KR, Pender NJ . Health promotion model -instruments to measure health promoting lifestyle:health-promoting lifestyle profile[HPLP II](adult version)[EB/OL]. [2018-12-12]. .
[14]	Becker H, Stuifbergen A, Oh HS , et al. Self-rated abilities for health practices:a health self-efficacy measure[J]. Health Val, 1993,17(5):42-50.
[15]	Thiamwong L, Maneesriwongul W, Malathum PP , et al. Development and psychometric testing of the healthy aging instrument[J]. Thai J Nurs Res, 2008,12(4):285-296.
[16]	Thanakwang K, Soonthorndhada K . Mechanisms by which social support networks influence healthy aging among Thai community-dwelling elderly[J]. J Aging Health, 2011,23(8):1352-1378.
[17]	Li T, Zhang YL . Social network types and the health of older adults:exploring reciprocal associations[J]. Soc Sci Med, 2015,130:59-68.
[18]	Scott SB, Munoz E, Mogle JA , et al. Perceived neighborhood characteristics predict severity and emotional response to daily stressors[J]. Soc Sci Med, 2018,200:262-270.
[19]	吴明隆 . 结构方程模型:AMOS的操作与应用[M]. 重庆: 重庆大学出版社, 2009: 53.
[20]	王梦怡, 彭华民, 朱慧劼 . 双重福利获得与老年人社会参与的关系研究—基于中国适度普惠社会福利数据库的实证分析[J]. 社会科学, 2018,457(9):103-111.
[21]	Granbom M, Kristensson J, Sandberg M . Effects on leisure activities and social participation of a case management intervention for frail older people living at home:a randomised controlled trial[J]. Health Soc Care Community, 2017,25(4):1416-1429.
[22]	武剑倩, 钞秋玲, 陈媛 . 家庭环境对老年人生活质量的影响:老化态度的中介作用[J]. 心理与行为研究, 2019,17(2):223-228.
[23]	杜鹏, 王红丽 . 老年人日常照料角色介入的差序格局研究[J]. 人口与发展, 2014,20(5):85-92,111.
[24]	van der Horst M, Coffé H . How friendship network characteristics influence subjective well-being[J]. Soc Indic Res, 2012,107(3):509-529.
[25]	陈卫, 段媛媛 . 中国老年人的空巢时间有多长?[J]. 人口研究, 2017,41(5):3-15.
[26]	Xie H, Chen PW, Zhao L , et al. Relationship between activities of daily living and depression among older adults and the quality of life of family caregivers[J]. Front Nurs, 2018,5(2):97-104.
[27]	Kim SY, Sok SR . Relationships among the perceived health status,family support and life satisfaction of older Korean adults[J]. Int J Nurs Pract, 2012,18(4):325-331.
[28]	马戎 . “差序格局”:中国传统社会结构和中国人行为的解读[J]. 北京大学学报(哲学社会科学版), 2007,44(2):131-142.
[29]	Eller LS, Lev EL, Yuan CR , et al. Describing self-care self-efficacy:definition,measurement,outcomes,and implications[J]. Int J Nurs Knowl, 2018,29(1):38-48.
[30]	戴悦, 张宝泉, 张文昌 . 中国老年人健康促进生活方式现状的Meta分析[J]. 中华护理教育, 2018,15(5):331-335.
[31]	李芬, 丁玲玲, 王力男 , 等. 上海市老年人医疗服务需求、利用及费用特征分析[J]. 卫生经济研究, 2018(6):26-29.